Catastrophe for Public Health in the Making

Washington, DC (July 1, 2010)—The National Association of County and City Health Officials (NACCHO) hosted a Capitol Hill briefing yesterday highlighting the devastating effect of job losses on one of the nation’s most important sectors: local health departments. Rep. Robert Andrews (D-NJ), Chairman of the Health, Employment, Labor, and Pensions Subcommittee of the U.S. House Committee on Education and Labor, recognized the importance of restoring the 23,000 local public health jobs that have been lost from January 2008 to December 2009, saying that these men and women represent one of our nation’s most valuable resources for prevention.

At the briefing, Andrews discussed the intersection of jobs and health, noting the importance of House Education and Labor Committee Chairman George Miller’s bill, the Local Jobs for America Act (H.R. 4812). The legislation, an important step in addressing the impacts of current local government budgetary shortfalls, has potential to enable local governments to provide local health departments with the resources necessary to reinstate laid-off personnel, return furloughed employees to full-time work, and restore core public health services.

"Local health departments play an essential role in our nation’s public health system because they protect the well-being of the American people. Each day, public health employees work in often unseen ways to help keep each community safe and healthy,” said Andrews. “To help ensure the safety of our nation’s communities and improve the health and well-being of our citizens, local health departments need more workers engaged in public health and prevention—not fewer. Therefore, it is essential that we act now, by passing legislation such as Chairman Miller’s Local Jobs for America Act, to provide localities with much-needed resources."

Peter Beilenson, MD, Health Officer for Howard County (MD), told the audience that his own department’s staff had recently been reduced by 30 percent. This year, budget cuts forced Howard County to eliminate its prenatal clinic—one of the only public clinics in the state providing prenatal care. The result is that 400 low-income pregnant women will have to seek care in distant hospitals, if they seek prenatal care at all.

Terrance Allan, Health Commissioner for the Cuyahoga County Board of Health (OH), said his state’s $8 billion deficit had led to similar staff and programmatic reductions. Cuyahoga County was forced to eliminate a tobacco prevention and control program that had successfully reduced local smoking rates. Now, 3,500 children will not receive peer-to-peer tobacco education and 400 adults won’t receive smoking cessation services.

“Job losses at local health departments make life riskier. Continued cuts to local health department budgets threaten Americans’ safety and health,” said NACCHO Executive Director Robert M. Pestronk. “For example, fewer staff to conduct inspections of water well drilling sites, sewage treatment facilities, and food service facilities like restaurants will make drinking water and food increasingly dangerous to consume. The ability to recognize and stop in a timely manner outbreaks of infectious diseases like influenza or tuberculosis is disappearing before our eyes.”

Local health departments from around the country are echoing the concerns raised today by Congressman Andrews and health directors Beilenson and Allan. A NACCHO survey released in May showed not only that roughly 15 percent of the entire local health department workforce has been lost, but that these job losses are both crippling the ability of local health departments to respond to emergencies and emerging threats and diminishing their capacity to conduct day-to-day operations of inspection and public service on which the health of Americans relies. Sixty-three percent of the U.S. population lives in the jurisdiction of a local health department that made cuts to at least one public service in 2009, such as an activity aimed at improving childhood nutrition, preventing tobacco use, or providing childhood immunizations.

"The mounting cuts to local public health departments are the beginnings of a national tragedy," said Georges Benjamin, MD, Executive Director of the American Public Health Association. "Without robust, sustained investment in our public health infrastructure, the capacity and ability of this country to protect the public and prevent diseases is being severely eroded.”

Follow news about budget cuts and job losses in local health departments across the country at www.naccho.org/newsmap.

About the National Association of County and City Health Officials The National Association of County and City Health Officials (NACCHO) represents the nation's 2,800 local governmental health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities.